Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00055
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9459 SW WASHINGTON SQUARE RD A14
Project: Footlocker /House of Hoops Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Duct & grill modifications for new tenant.
Contractor: GREY WOLF HVAC INC. Owner: PPR WASHINGTON SQUARE LLC
7306 NE 37TH AVE BY THOMSON PROPERTY TAX SERVICES
VANCOUVER, WA 98665 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 360- 635 -6117 PHONE:
FAX: 360- 326 -8506
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/27/2012 $347.71
Class of Work: ALT Type of Const: Plan Review 01/27/2012 $86.93
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 01/27/2012 $41.73
Stories:
Project Valuation: $9,950.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Fumaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $476.37
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to 04 1 i calling 503.232.1987 or 1.800.332.2344.
/ /
Issued By: �// / Permittee Signature: �� jO�C /'�G�"/
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM (FRI ).JAN 27 2012 9: 38 /ST. 9: 32 /No. 7523119313 P 3
Mechanical Permit Applicatio. n, FOR OIF FICE t SI.ONl.l
City of Tigard CEIVED Receives
1,1 g Permit No.:
• 13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
i f�o?Q /alJ
III Phone: 503.718.2439 Fax: 503.598.1960 . 1 \I 2 7 201 2 Date/B
a /B y : w Other Permit:
D
TIGARD Inspection Line: 503.639 Date Ready /By: Surfs: ® See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
__._. ._�_ _.._....-- _..., � ='". --^,• • '`
Mechanical permit fees* are based on the value of the work
❑ New construction El Addition /alteration /replacement • performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ® Other: Tenant Improvem mechanical materials, profit.
equipment, labor, overhead, , an pr
Value: $
5
❑ I - and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
:._ � � � �=-=,s ',.. - = =-• ��` � , Heating/cooling:
� = � .. • sue_
" - °- - • ""'�' °-`-` - �' �-°- ��< Air conditioning
Job site addressW Washington Square Rd., Sp. Al4 (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City/State/ZIP: Portland, OR 97223 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: A14 Project name: House of Hoops (FporLeekEel) Heat pump
(requires site plan showing placement) 61.06
Cross street /directions to job site: Duct work 23.32
Washington Square Mall Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: _ Other fuel appliances:
_43 , �;�• -�,M � �• =' =: � Water heater 23.32
as fireplace 33.39
HVAC - cleaning, relocating GRDs, etc. Flue vent for water heater or gas
fireplace 23.32
• Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
°-v --- �--- �--..,,. -- �--- Chimney/liner/flue/vent ,.�._�_ W .;;�� . • . _'_r __....., ..:...... _. ` = 9-•• pia ��� =w
'-- mney 3 32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Clothes dryer exhaust • 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
.j z&ciii A r` t� ,:. o Attic /crawlspace fans 23.32
Business name: Grey Wolf HVAC, Inc. Other. 23,32
Fuel piping:
Contact name: Darrell Osborne $14.15 for first four; $4.03 for each additional
Address: 7306 NE 37 Ave. Furnace, etc.
Gas heat pump
City / State/ZIP: Vancouver, WA 98665 Wall/suspended/unit heater
Phone: (360) 635 -6117 Fax:: (360) 326 -8506 Water heater
Fireplace
E -mail: dosborne @greywolfhvae.eom Range
.Barbecue
Business name: Grey Wolf HVAC, Inc. Clothes dryer (gas)
Other.
Address: 7306 NE 37 th Ave.
City /State/ZIP: Vancouver, WA 98665 Subtotal , 77 7/
Minimum permit fee (590.00)
Phone: (360) 635 -6117 Fax (36 326 -8506
., � � Plan review (25% of permit fee) ge
CCB lie.: 165139 �h
l State surcharge (12% /o ofpermit fee) y
g ; � I . �� �� TOTAL PERMIT FEE �? / p n 18 7,
Authorized si natur - . � 1� ' � This permit application expires if a permit is not obtained wit in 180
t 14�; days after it has been accepted as complete.
Print name: Darrell Osborne Date: 1/27/12 * Fee methodology set by Tri- County Building Industry Service Board
I. Building 'Permits'.MEC- PmuilApp.due 09 %09/10 440 -4617T (II'02,COM'WEB)